Division of Gastrointestinal Oncology, Shizuoka Cancer Center, 1007 Shimonagakubo, Nagaizumi-cho, Sunto-gun, Shizuoka, 411-8777, Japan.
Int J Clin Oncol. 2013 Feb;18(1):10-6. doi: 10.1007/s10147-011-0335-y. Epub 2011 Oct 22.
Although S-1 plus cisplatin (SP) therapy is recognized as the standard treatment for advanced gastric cancer (AGC) in Japan, its safety and efficacy in elderly patients have not been investigated sufficiently.
We retrospectively reviewed the data of 58 patients with AGC selected from 82 consecutive patients who were ≥70 years old and were treated with SP or S-1 monotherapy as the first-line therapy. In SP, S-1 (40 mg/m(2), bid) was administered for 3 weeks and cisplatin (60 mg/m(2)) on day 8, every 5 weeks. In S-1 monotherapy, S-1 (40 mg/m(2), bid) was administered for 4 weeks, every 6 weeks.
SP and S-1 was administered in 21 and 37 patients, respectively. There were some differences in patient characteristics between the treatment groups, such as histological type (P = 0.16); the presence of liver metastasis (P = 0.07); and the presence of peritoneal metastasis (P = 0.02). The incidences of grade 3/4 hematological toxicities were 57% (12/21) in the SP and 35% (13/37) in the S-1 group (P = 0.17). Those of non-hematological toxicities were 14% (3/21) and 14% (5/37) for anorexia, 10% (2/21) and 14% (5/37) for fatigue, and 5% (1/21) and 5% (2/37) for nausea in the SP and S-1 groups, respectively. Median progression-free survival and median overall survival in the SP and S-1 groups were 5.0 and 5.2 months, and 14.4 and 10.9 months, respectively.
SP and S-1 therapy were both feasible in elderly patients, though there is the risk of a high incidence of hematological toxicities.
尽管 S-1 联合顺铂（SP）疗法已被确认为日本晚期胃癌（AGC）的标准治疗方法，但针对老年患者，其安全性和疗效尚未得到充分研究。
我们回顾性分析了 82 例连续接受 SP 或 S-1 单药一线治疗的年龄≥70 岁 AGC 患者的资料，其中 58 例患者纳入研究。SP 组：S-1（40 mg/m2，bid）治疗 3 周，顺铂（60 mg/m2）第 8 天给药，每 5 周重复；S-1 单药组：S-1（40 mg/m2，bid）治疗 4 周，每 6 周重复。
21 例患者接受 SP 治疗，37 例患者接受 S-1 治疗。两组患者在组织学类型（P = 0.16）、肝转移（P = 0.07）和腹膜转移（P = 0.02）等方面存在差异。SP 组和 S-1 组的 3/4 级血液学毒性发生率分别为 57%（12/21）和 35%（13/37）（P = 0.17）。非血液学毒性的发生率为厌食症 14%（3/21）和 14%（5/37），疲劳 10%（2/21）和 14%（5/37），恶心 5%（1/21）和 5%（2/37），两组间差异均无统计学意义。SP 组和 S-1 组的中位无进展生存期和总生存期分别为 5.0 个月和 5.2 个月，14.4 个月和 10.9 个月。
SP 和 S-1 治疗在老年患者中均可行，但存在血液学毒性发生率高的风险。
